Anaes Cases · Electricity, diathermy & theatre safety
The poorly applied return plate and the burn risk
The short case — the return-plate burn from the poor contact (the bony prominence, the small area). The current density at the plate rises when the contact is poor; the alternate-site burns (the ECG electrode) occur when the plate is detached and the current returns through another path.
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Prompt
After a long case, a burn is found under the diathermy return plate site. The plate had been applied over a bony prominence and the contact-quality monitor had alarmed intermittently. Explain the mechanism and the prevention.
Presentation
After a three-hour laparotomy, a 4 by 4 cm partial-thickness burn is found on the patient's hip, beneath the diathermy return plate. The plate had been applied over the greater trochanter (a bony prominence), and the contact-quality monitor had alarmed intermittently during the case. The surgeon used the monopolar diathermy extensively. Explain the mechanism and the prevention.[34181253]
References2ShowHide
- [2]Link T. Guidelines in practice: electrosurgical safety. AORN Journal, 2021.PMID 34181252
- [34181253]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.